The clinical characteristics, managements, and outcomes of acute myocardial infarction in osteoarthritis patients; a cross-sectional analysis of 6.5 million patients

ABSTRACT

Objectives

The prevalence of osteoarthritis (OA) and cardiovascular disease are increasing and both conditions share similar risk factors. We investigated the association between OA and receipt of invasive managements and clinical outcomes in patients with acute myocardial infarction (AMI).

Methods

Using the National Inpatient Sample, adjusted binary logistic regression determined the association between OA and each outcome variable.

Results

Of 6,561,940 AMI hospitalizations, 6.3% had OA. OA patients were older and more likely to be female. OA was associated with a decreased odds of coronary angiography (adjusted odds ratio 0.91; 95% confidence interval 0.90, 0.92), PCI (0.87; 0.87, 0.88), and coronary artery bypass grafting (0.98; 0.97, 1.00). OA was associated with a decreased odds of adverse outcomes (in-hospital mortality: 0.68; 0.67, 0.69; major acute cardiovascular and cerebrovascular events: 0.71; 0.70, 0.72; all-cause bleeding: 0.76; 0.74, 0.77; and stroke/TIA: 0.84; 0.82, 0.87).

Conclusions

This study of a representative sample of the US population highlights that OA patients are less likely to be offered invasive interventions following AMI. OA was also associated with better outcomes post-AMI, possibly attributed to a misclassification bias where unwell patients with OA were less likely to receive an OA code because codes for serious illness took precedence.

KEYWORDS:

• Acute myocardial infarction
• osteoarthritis
• invasive managements
• electronic health record data
• epidemiology

Acknowledgments

The authors would like to acknowledge Dr. Jessica Potts for her guidance and statistical expertise. SSP would like to acknowledge the Royal College of Physicians and the Wolfson Intercalated Award for the financial support allowing SSP to undertake and intercalated MPhil degree during his undergraduate medical training. The funder had no role in the preparation or publication of this manuscript.

Author contributions

MA. Mamas and R. Wilkie conceptualized and designed the study. MO Mohamed acquired the data. MA Mamas, R Wilkie, and MO Mohamed provided statistical expertise. SS Parmar analyzed the data and drafted the article. MA Mamas, R Wilkie, MO Mohamed, and SS Parmar participated in the critical revision and final approval of the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2024.2311696

Additional information

Funding

This paper was not funded.